Booking Enquiry Form
Practical Courses - sections A, B and C to be completed Theory Courses - please complete section A and C only
Terms and Conditions apply to all courses.

 

Section A
Title
Name
Address
Postcode
Phone
Email
Date of Birth (dd/mm/yy)
Nationality
Where did you hear about us?
   
Course Details  
Course required
Preferred Date(s)
Sailing Experience
(if any)
RYA Qualifications
(if any)

 

Section B
Health I declare to the best of my knowledge I am not suffering from a medical disability such as Angina, Asthma, Diabetes, Epilepsy, giddy spells, or any other heart condition, and am fit to participate in the course. Please tick if you agree, otherwise please give details below.
 

The listed illnesses do not necessarily preclude you from taking part, but we must have the relevant details. Please detail level of severity and medication received
Swimming     Can you swim 50m with clothing? yes no
Special Dietary Needs Please Specify
Emergency Contacts
Name
Phone
Doctor's Details
Doctor's Name
Doctor's Phone

 

Section C - Booking Conditions
  
You are strongly recommended to arrange your own insurance cover, for cancellation, injury, personal belongings and personal liability – we recommend that you use this link to contact Topsail Marine Insurance as per item 3 of our terms and conditions.
Visit Topsail Insurance
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Do you have your own insurance? yes no
Before booking on any of our courses, please read and understand our booking conditions. Click here to read our Booking Conditions.
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By clicking the Agree & Submit button you are confirming that you have read and accepted the Booking Conditions.
 
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